Theresa May: I thank the Leader of the House for giving us the business for the week after the recess. I am grateful that the Children and Adoption Bill has found a place in the business of the House for that week.
	The right hon. Gentleman and other hon. Members will have noticed that we will use our Opposition day on 1 March to discuss dentistry and the treatment of cancer patients in the NHS. I asked last week for a debate on dentistry, as did my hon. Friend the Member for Congleton (Ann Winterton), and the Leader of the House suggested that Members should raise the issue in today's debate on NHS inequalities. He was being somewhat disingenuous in saying that because the debate today not only covers the whole of the NHS, but will probably last for only two and a half hours. There will not be much time to talk about dentistry.
	In 1999, the Prime Minister gave a commitment that by the end of 2001 everyone would have access to an NHS dentist—a commitment on which he has failed to deliver. However, hon. Members may care to know that the Government have a radical and innovative answer to ending the queues of people waiting to sign up to a new NHS dentist. They are going to ban people from queuing and force them apply by phone or post. We need a debate about the real answers to the problems, and we will give hon. Members that debate.
	On the issue of cancer patients and the use of Herceptin, and following yesterday's court decision—which revealed that, despite the comments by the Secretary of State for Health last autumn, the Government had not changed their policy—will the Leader of the House ensure that the right hon. Lady makes a statement to the House on Herceptin before the debate on 1 March?
	We waited a long time for it, but I was pleased to hear the Leader of the House announce the date of the Budget today. It is a pity that it was announced on Sky News before he could announce the date in this House. Talking of long waits, when will the education reform Bill be published?
	I realise that referring to the economy usually brings a torrent of statistics from the Leader of the House about inflation, interest rates and employment, but yesterday we saw the biggest rise in unemployment for 13 years, and there are serious underlying problems that need to be addressed, particularly the position of young people. Does he share my concern that over the past year there was a 28 per cent. increase in youth long-term unemployment; the number of economically inactive 18 to 24-year-olds has risen by nearly a quarter since Labour came to power; and that the number of young people who are not in education, employment or training has risen to 1.2 million? The Chancellor of the Exchequer said that he would not be satisfied until the Government had removed the scar of long-term unemployment from the face of Britain. Yesterday's figures show that he is failing to achieve that goal, so will the Leader of the House make time for a debate on youth long-term unemployment?
	Finally, on a day when a review of the work of the Electoral Commission has been announced, I note that the Leader of the House has previously said that in order to engage people in the electoral process we should force them to vote by making it compulsory and by fining people who do not vote. Is that still his view, or has he now realised that the more people who vote at the next general election, the bigger the Conservative majority?

Jim Devine: I do not know whether my right hon. Friend has had a chance to look at early-day motion 1661, which is in my name and that of my hon. Friend the Member for Dundee, West (Mr. McGovern), which states:
	[That this House congratulates the Bishop of Dunkeld, Bishop Vincent Logan on the Silver Jubilee of his episcopal ordination; notes that Bishop Logan was ordained Bishop of Dunkeld in the Cathedral Church of St Andrew, Dundee on 26th February 1981; further notes that he was educated in Bathgate, Blairs and Drygrange and ordained to the priesthood in the Archdiocese of St Andrews and Edinburgh in 1964 and that he served Episcopal Vicar for Education in the Archdiocese of St Andrews and Edinburgh; further notes Bishop Logan's continuing interest in education and in the formation of candidates for the priesthood; thanks Bishop Logan for his hard work in the Diocese of Dunkeld and beyond; and wishes Bishop Logan many more years of service.]
	It congratulates Bishop Logan on his ordination 25 years ago as a bishop in Scotland. It is his silver jubilee next week, and he is a well known and respected figure in Scottish society. Will my right hon. Friend join in with the congratulations?

Geoff Hoon: The hon. Gentleman is referring to long-standing arrangements put in place by the Governments of the respective countries. They have been in place for a very long time, under not only under this but previous Governments. It would require a great deal of careful thought before we could replace such long-standing understandings.

Julian Lewis: Through the Leader of the House, may I express my thanks for the great courtesy shown by the Downing street police and staff at the door to a group of second world war veterans handing in a letter yesterday to the Prime Minister on behalf of the widow of the late Lieutenant Norbury, who was wrongly denied a war pension? I hope that my meeting on the subject with the Minister for Veterans this afternoon will lead to a positive outcome.
	May we have a statement or debate on the way in which criminal sentences are described to the public when they are imposed? Last week we saw a great deal of publicity that Abu Hamza had been sentenced to seven years in prison, whereas the reality is that he will serve three and a half years. Would it not be more honest to tell the public that people have been sentenced to a range from three and a half to seven years, so that people will not be disillusioned when they see that those whom they thought had deservedly been put away for a long time are out on the streets all too soon?

Danny Alexander: I intend to say something later about the disincentives to work that will continue if the orders are passed.
	People outside may look forward to receiving uprated benefits or pensions. How those benefits are delivered, and whether people will be able to take advantage of them, is an issue of fundamental importance. The Under-Secretary of State will know that some 4.3 million people receive the benefits in pensions that we are discussing via a Post Office card account. He will know, because we discussed it in Westminster Hall yesterday—

Danny Alexander: The hon. Gentleman makes an extremely good point. If, as a result of the Government's policy, the means of access to benefits and pensions—local post offices in rural areas or deprived urban areas—is removed, the uprating should include an amount that makes it possible for people to gain access to those benefits and pensions. Otherwise, while there may be a superficial uprating, increased costs will mean an overall downrating for those people. I hope that the Minister will address that issue, and particularly the question of when people living in such areas might lose the ability to access benefits in the manner of their choosing. I hope that the Government will provide time in the near future for a full debate on this issue, because Ministers have so far been unable to address it on the Floor of the House.
	I come to the future of disability benefits, with which the orders before us also deal. We Liberal Democrats will make a formal submission on this subject in response to the Government's Green Paper on welfare reform, but there are a few points that are worth making in the context of today's debate. Although we endorse, for example, the various forms of support being offered to people on incapacity benefit to get them back into work and, therefore, off the benefit currently provided in the pathways to work pilot areas, if such support is to be extended throughout the country to all people in receipt of incapacity benefit it needs to be properly funded. The Government estimate that the pathways to work project costs some £400 per claimant. Based on the latest annual figures for people commencing incapacity benefit claims, it would take some £220 million a year to fund a national roll-out at the same level. Yet the Government are offering only £360 million over two years. If the resources are spread too thinly, we will not see results and we will let down all those claimants who want to find work. That is especially true at a time of rising unemployment.
	Conditionality of benefits has been a major feature of the debate on the future of benefits such as jobseeker's allowance and incapacity benefit. That debate continues.

Graham Stuart: That is true, but it is why it is all the more shameful and sad that the Government have squandered the unparalleled opportunity presented by the transformed economy that they inherited and have let down the people who most need help.
	The Minister used the interesting word "consensus". I have been in the House only since last May, and I try not to be cynical, but whenever I hear a Minister use that word I know that he is presiding over a system that is chaotic and failing. That is why, in a desperate bid to shore up his weakening political position, he uses that word to seek the support of the Opposition.
	However, the good news from my hon. Friend the Member for Bury St. Edmunds is that the Conservative party is always prepared to work for the good of the most vulnerable people. We will work to achieve consensus to support them and give them the dignity of work. People want dignity, not means-testing.
	I am nervous of touching on the new deal but shall do so only in passing and certainly less than the Minister did. Only 15 per cent. of people aged more than 25 who were out of work when the so-called successful new deal was introduced—that is, only one person in seven—have returned to work and so no longer need to claim benefits. Six out of every seven benefit claimants have been failed by that enormously expensive and bureaucratic programme.
	I welcome the Conservative party's continuing commitment to programmes that will help and support people and get them into work. In contrast to what too often amounts to political posturing among Labour Members, I do not even mind if we keep the new deal name. That is a matter of indifference to me, as long as we move away from the politics of failure and get all those people still languishing out of work back into employment. That is what the Conservative party is about. That is why we transformed the economy, and that is the opportunity that I hope that we will take on again when we next form the Government.
	The Minister referred to the number of children in poverty. He will be aware, although he is no longer in his place, that the percentage of children experiencing persistent low income—those in the unhappy state of remaining below 60 per cent. of median household income in at least three out of four years—was 16 per cent. in 1996–97 and remained at 16 per cent. for the following three years to 1999–2000. We need to recognise that far too many children still live in poverty and that the Government have not delivered the transformation that they promised. I hope that we will see fewer eye-catching initiatives and more hard work to make the systems that we already have work better. When we have a Conservative Government, we will make the systems work better. We will be less interested in headlines and more interested in reducing poverty for those with least.
	The Minister's words on pensions were hardest to take. As my hon. Friend the Member for Bury St. Edmunds said, Labour's first Minister with responsibility for welfare reform said last year that when Labour came to power we had one of the strongest pension systems in Europe. Now we have one of the weakest. That is a searing indictment of the Government's failure. They have removed opportunity from hard-working people and replaced it with means-testing. I have yet to meet a constituent, whether from the far left like so many Labour Members who rebel against the Government, or from the right, or of no known political persuasion, who wishes to spend their life working hard and paying tax in order to end up on means-tested benefit. They do not want to have to fill in 24-page forms to get pension credit or 12-page forms to get their council tax benefit.
	When I attended the Hornsea pensioners annual Christmas lunch, I sat beside an upstanding, hard-working, socially contributing and economically successful member of the community who, in his old age, has, because of the Government's £5 billion raid on pensions, ended up in need of means-tested benefits in order to live properly—[Interruption.] Ministers may laugh at the predicament of hard-working, decent people who are forced into relying on means-tested benefits at the end of a life in which they have suffered no ill-luck and no great illness. They consider themselves successful members of our society. They have always worked, they brought up their children and they tried to do the right thing. This Government have made such people feel like beggars from the state. The gentleman whom I sat next to at Christmas lunch told me that he had seen adverts saying, "It's yours: claim it". So, he filled out all the forms and sent them off. By return, he was told that his building society accounts had not been sent in original form and was asked to supply every last one, even one that had £80 in it. He told me that he chucked the lot in the bin. The 1.5 million people in the same situation deserve better, but they have been let down by a Government who are addicted to means-testing instead of providing dignity for people in their old age.
	Age Concern estimates that more than 2 million retired people are living in households with incomes below the Government's official poverty line. I would have thought that Labour Members would be campaigning vociferously on behalf of women, who benefit least from the current system. We know that fewer of the recently retired have money coming in from an occupational pension. We also know that 1 million people have seen their occupational pension schemes wound up—more than 60,000 schemes—because of the policies of this Government, who have raided pensions to the tune of £5 billion a year. That is not a modern, active and inclusive welfare state. For Ministers to persist in saying that it is nothing short of a deception of the British people, and I hope that it will be increasingly recognised as such.
	Pensioners, people on incapacity benefit and people on the new deal—in other words, some of the most vulnerable people in our society—are not well served by the benefits uprating today. They are being let down. The basic state pension, for people who have contributed all their lives, was 21 per cent. of average earnings when this Government came to power, but it is now just 15.9 per cent. That is the legacy that this Government will leave.

Graham Stuart: That is my next point. At the election, the Conservative party laid out proposals to help to lift pensioners out of poverty, to bring them dignity and not means-testing, and to bring back the link between average earnings and the state pension. Labour Members will point out that that link was removed by the Conservatives, but I ask them when that happened. It was in 1980, at the end of a decade in which Labour Governments had brought the economy of this country to its knees. That is why we had to remove the link. By 1997, we had transformed the economy, which is why Labour Members should join Help the Aged, Aged Concern and the National Pensioners Convention—indeed, with everyone associated with pensions except the Chancellor of the Exchequer—in believing that we should bring back the link between average earnings and the state pension. We should not allow the number of people dragged into the hole between pension credit and the state pension to increase. It is beyond belief that we can even consider having 70 per cent. of people dependent on this Government's mean means-tested benefits in as short a time as 44 years.
	We need a Conservative Government to lift people out of poverty, because they want dignity, not means-testing. We need to bring back the link, and we need to stop the Chancellor of the Exchequer's pernicious, poverty-inducing increases in council tax. We had proposals to deal with those issues at the last election, and I look forward, under the leadership of my right hon. Friend the Member for Witney, to my party coming forward with a considered position that will help to bring dignity back to the people of this country and provide hope for those with least.

Caroline Flint: The work on health trainers was developed by talking to those on the ground about how we can engage people who are not presenting themselves to services in the traditional way. We have asked—[Interruption.] I shall finish my sentence, if the hon. Member for South Cambridgeshire will allow me. We have asked different areas of the country to provide information on such services, and we will evaluate their impact. [Interruption.] Both the life check and health trainer initiatives emerged from the White Paper consultation process. We will establish an expert stakeholder group, which will examine how the initiatives will work.
	This is not about adding more checks—there are already opportunities for different checks—or adopting a one-size-fits-all approach; nor is it not just about sickness: it is about health and finding a practical, non-burdensome way of engaging with people at different points in their life and getting them to think about their health. [Interruption.] For some people, relatively little action will be required. Many will be able to carry out a self-assessment and will need nothing more. But for others, a health check might be the spur for health providers to think about the services that they should provide, and for the individual to consider how their lifestyle is affecting their future health.

Stephen Williams: We have had a wide-ranging debate, although we have focused rather narrowly on Surrey in the past 20 minutes or so. I want to go back to where we left off on Tuesday night, when, collectively, we made probably the biggest advance in public health legislation for decades by passing a full ban on smoking.
	The prevalence rates for smoking are illustrative of the wider health inequalities that exist throughout society. I looked at the statistics for the south-west of England. The highest prevalence of smoking is in my own city of Bristol, where it is 33 per cent., and the lowest is in an area that has been mentioned several times today, east Dorset, where it is 20 per cent. There are also great variations within areas. In the Henleaze ward in my constituency the figure is 12 per cent., while in the Knowle West ward, in Bristol, South, the constituency of Paymaster General, it is as high as 56 per cent. Those wards are only about two and a half miles from each other. There is an enormous variation in quite a small geographic area. In broadly middle-class parts of the city, the prevalence of smoking is below 20 per cent. In working-class or deprived communities it is always over 40 per cent., and in some areas over 50 per cent. Throughout the city, the rates are higher among men than among women.
	Perhaps the key vote on Tuesday night was on whether we should remove the exemption for private members' clubs. Several Members, mainly but not exclusively Conservative, said that attendance at a private club was a matter of choice. Had I been called to speak, I would have said that where people go in the evenings is often not a matter of choice. In many parts of the country, particularly south Wales, where I grew up, going to a private members' club rather than a pub is the norm. If we had not removed that exemption, health inequalities in such areas would have widened rather than narrowing.

Stephen Williams: That is interesting. I assume that the hon. Gentleman is referring to the right hon. Member for Liverpool, Wavertree (Jane Kennedy). I admit that I did not note that she voted for the exemption, but I am sure that the people of Liverpool will take careful note. As the hon. Gentleman will know, an excellent organisation called Smokefree Liverpool is promoting a private Bill to impose a full smoking ban throughout Liverpool—of course, it will not now be necessary—led by Liberal Democrat-controlled Liverpool city council.
	Health outcomes are not always a matter of choice. They are often related to the accident of where people were born, their family circumstances, the occupation of family members, the housing in which they were brought up and the degree of poverty in their household. The hon. Member for South Cambridgeshire (Mr. Lansley) quoted from briefing that I too received, from the British Thoracic Society, about chronic pulmonary diseases such as bronchitis, emphysema and asthma. Those diseases can often be linked with occupations in declining industrial areas. It is a complicated picture.

Andrew Gwynne: I welcome the debate and am pleased to contribute to it. My constituency is in eastern Greater Manchester and covers two local authority areas. The first, Tameside, like much of east Manchester, contains a number of deprived areas, which consequently have serious public health problems. The second, Stockport, is considered one of the most affluent areas in north-west England, but, despite that, it must be recognised that there are areas of serious deprivation in Stockport, including parts of the borough that form my constituency. In socio-economic terms, they have much more in common with Tameside and east Manchester than with the prosperous areas of Bramhall and Cheadle in the south of the borough.
	More than 100 years ago, at the height of the industrial revolution, the city fathers of Manchester sought to make a radical improvement in the health of the growing population by ensuring a supply of clean drinking water from the Lake district. Almost overnight, the rates of cholera and other preventable diseases plummeted. That, along with other sanitation services and the provision of public parks—I believe that one of the first municipal parks in the country was in Greater Manchester—was the first major step towards greatly improving public health in our major cities. With the introduction of the NHS in the late 1940s, there was a remarkable improvement in public health. I am proud of the fact that the former Denton urban district council was among the first councils to adopt the Clean Air Act 1956.
	As a result of all those decisions, life expectancy has increased dramatically and our quality of life has been transformed from the standard that my grandparents' parents were used to. That said, health inequalities have continued, despite the steps forward over the past century. It is sad but true that to this day there remains a direct correlation between one's background, housing, environment and income, and one's health.
	I am proud that the Government that I was elected to support committed themselves at the general election to
	"tackle the long-standing causes of ill-health and health inequality by . . . tough targets to close the health gap to cut deaths in poorer communities and among poorer children".
	That will have a massive impact on my constituents, and for the better.
	Mr. Deputy Speaker, with your indulgence, I wish to focus on the work undertaken by agencies throughout Denton and Reddish to tackle issues of concern. First, as a result of the single regeneration budget round 5 funds, there has been tremendous investment in the regeneration of the most deprived parts of the constituency. In Haughton Green, SRB funding has enabled the provision of innovative community-based health services in a new joint community and health centre. The services are provided by numerous agencies, but come together under one roof to provide local people with access to housing and homeless services, local health services, benefit advice, access to the credit union, child care help and advice for young people, including advice related to tackling sexual health issues and teenage pregnancies. That superb facility has provided the local community with a new resource.
	Adjacent to the Haughton Green community and health centre are the Haughton Green playing fields. Again, spearheaded by SRB 5 and the commitment of the neighbourhood forum and local councillors, major funding was secured to refurbish completely the rather derelict, overgrown waste of space. Through community consultation, a bid for doorstep green funding was secured and that public open space in an urban area that lacks good-quality open space has been transformed into a community asset to be proud of. Not only were the football pitches drained, new play areas for toddlers, children and teens, and a new floodlit multi-purpose games area were provided. Even the old bowling green was restored after being out of action for at least two decades. Now, the area is used by all the community. A bowling club has been established and the sports development unit at Tameside metropolitan borough council ensures that the state-of-the-art sports facilities are well used by local youths in particular. That is crucial, not least to ensure that the ticking obesity time bomb is diffused in communities such as Haughton Green.
	I also want to highlight the impact that Sure Start is having in my constituency, offering access to a variety of services such as child care and health advice, providing new parents with the skills necessary to be a parent, and developing simple skills such as cooking. These are crucial in areas such as Haughton Green and other parts of Denton and Reddish. Sure Start is beginning to address long-standing problems and I am proud that my constituency will eventually benefit from six Sure Start centres. I point especially to the good work being done by Reddish Vale early years centre in the Stockport part of my seat, which provides all the services that I mentioned. It has undoubtedly been a resounding success.
	I draw to the attention of the House the work of Tameside youth service and the Tameside and Glossop primary care trust in providing services to young people throughout the borough. Whether we like it or not, many teenagers find themselves in situations where they have access to alcohol and sometimes to drugs. Usually as a consequence of being under the influence of those substances, they may be more inclined to have, or be at risk of having, unprotected sex.
	In connection with the borough's health targets and the crime and disorder partnership, the joint service offered by the PCT and the youth service provides local young people with an all-in-one support service on drug abuse, alcohol abuse and sexual health issues. As a result of the latter, teenage pregnancy levels in the borough are starting to show an improvement. I commend to the Minister the recent report of Tameside's health and education services scrutiny panels on teenage pregnancies, which describes in much more detail the progress being made in the borough.
	Finally, I highlight the proposals of Tameside and Glossop primary care trust to devolve primary care services to local communities. Three primary care centres are being developed which will provide services far more locally than ever before. A range of services previously available at only the district hospital or outside the borough will be available in the state of the art new centres. Importantly in the context of the present debate, the centres will be located in some of the most deprived wards in the borough. One of the wards, St. Peters, which is partly in my constituency and partly in the constituency of Ashton-under-Lyne, is in the top 5 per cent. of deprived wards in the whole country.
	The availability of services locally is important because too many people from areas like St. Peters do not have access to good services if those are not available in the communities. Whether because of low car ownership or poor bus services, if facilities are too far away, people will not access them, so I commend Tameside and Glossop primary care trust for taking the services directly to those communities.
	Leading and responding to the debate is a Health Minister, and a very good one at that, but I could fill up the Front Bench for this, because tackling health inequalities is a responsibility not just of the Department of Health. I have spoken of the single regeneration budget, community regeneration, the crime and disorder strategy and sports development, but I could also mention the hundreds of millions of pounds being invested by New Charter Housing and Irwell Valley Housing through stock transfer, and by Stockport Homes through an arm's length management organisation, which will bring the area's housing stock up to the decent homes standards.
	I could talk about the new schools being built and the innovative joint services being developed with the NHS and social services, or the new jobs coming into the area through redevelopment and regeneration schemes. Put simply, tackling health inequalities involves cross-cutting responsibilities. When that is looked at a whole, the Government have much to be proud of.